Recurrent spontaneous abortion (RSA) and endometriosis are female reproductive tract disorders that can lead to infertility and/or the inability of a woman to carry a fetus to term. RSA is defined as a condition in which a woman suffers from three or more consecutive spontaneous miscarriages. The etiology of this condition is poorly understood, but it has been linked to genetic, hormonal, anatomic, and/or immunologic anomalies and infection.
More information is known about endometriosis, a pathology characterized by the presence and growth of ectopic endometrial tissue outside the uterine cavity. Endometriosis is thought to be caused by retrograde menstruation, a process in which endometrial fragments are transported into the pelvis. Implantation and proliferation of such tissue fragments at ectopic sites can lead to pelvic pain, dyspareunia and even infertility. About 10% of reproductive age women suffer from endometriosis, and 30 to 40% of these experience infertility. Syrop C. H. and J. Halme, In: Wallach E. E., Kempers R. D., eds. Modern trends in infertility and contraception control. Boca Raton (Fla.), Year Book Medical Publishers, Inc, 343–51, 1988.
Unfortunately, the pathophysiology of RSA and endometriosis is not well understood. One hypothesis is that an unfavorable environment created by an immune/inflammatory-related condition in the peritoneal cavity and/or reproductive tract (e.g., ovary, fallopian tube, and endometrium) contributes to these disorders. Exposure of gametes to such an environment then leads to failure in oocyte maturation, ovulation, fertilization, and early embryonic development. Thus, a more complete understanding of the molecular and cellular events that underlie the pathophysiology of the female reproductive tract should lead to better methods for detecting, preventing, and treating disorders such as endometriosis and RSA.